most of my acne is under the skin non-inflamed ...the kind that only clears when I go for extractions. the majority is on my cheeks which was never an area of concern. My skin at present is hard to show with photos as it mostly looks like goosbumps not red bumps.

I am cleansing with REN Clay, and moisturizing with REN Hydro calm (at work as it isnt greasy) and cetaphil at home morning and night as it works well but is oily looking. My exfoliants are a manual facial scrub by "mineral from the dead sea", and the aveda Kinetics liquid exfoliant. Once my skin gets super dry I will be using a simple at home chemical peel from the REN line as well.

Hello person from Alberta! I am from Manitoba, so we would be neighbours if it wasn't for that ridiculous province in between (kidding). I have just started my second round at age 35. I did my first at 26 and stayed relatively clear until I went off the pill about a year ago. The acne slowly started creeping back, but we were trying to get pregnant so I tried to control it with topical stuff. Of course, nothing worked. I went to the dermatologist and she prescribed Biacna (aka Ziana). I don't know what went wrong, but within a couple weeks of using it my face went NUTS. Worse than ever. I kept going, assuming it was some sort of initial breakout, but after 8 weeks it was so bad, I couldn't take it anymore and the likelihood of it getting better seemed slim. Back to the derm who took one look at me and said 'so, you want to try the Accutane again?'. Oy. So, back on the pill, back on the accutane. From the pics, I think I'm a little worse off than you. Tons of stuff under the surface and a handful of big red angry ones that don't cover up no matter what you do. I've never had extractions. Tell me more about this!

My last course went so smoothly, but maybe that's just how I remember it. This one, not so much. It has only been a week, but things are still getting worse instead of better. This never happened last time, but it wasn't so bad when I started I guess. It takes all my effort to leave the house in the morning, and that can only be done with a few layers of foundation.

I'm losing hope. It feels like no matter what, things just get worse and worse. I know I need to give it time, but after giving the Biacna time and ending up where I am, I am so tired of trying to convince myself that things will get better *soon*, when soon never comes. So I guess I'm looking for someone one who understands to go through this with for support? I don't have the guts to start a log of my own. How is your first day? Mine was weird - my nose hurt for unknown reasons (gone now). I am finally starting to get chapped lips, and I have never been so happy to have them! Now if only the rest of my face would admit I'm on Accutane. . .

My last course went so smoothly, but maybe that's just how I remember it. This one, not so much. It has only been a week, but things are still getting worse instead of better. This never happened last time, but it wasn't so bad when I started I guess. It takes all my effort to leave the house in the morning, and that can only be done with a few layers of foundation.

I'm losing hope. It feels like no matter what, things just get worse and worse. I know I need to give it time, but after giving the Biacna time and ending up where I am, I am so tired of trying to convince myself that things will get better *soon*, when soon never comes. So I guess I'm looking for someone one who understands to go through this with for support? I don't have the guts to start a log of my own. How is your first day? Mine was weird - my nose hurt for unknown reasons (gone now). I am finally starting to get chapped lips, and I have never been so happy to have them! Now if only the rest of my face would admit I'm on Accutane. . .

Yo thepuddlebug, also canadian.

Please consider a log, I seriously annoy myself over the fact that I didn't keep up with my first log but yeah. Acne is like...this weird battle you can't exactly predict winning? I mean, we may be on Accutane but we know it isn't the end yet. I plan on being completely paranoid once off the drug. Even 10 years post drug I will be paranoid. Because, I've already had acne for like...15 years? so. Yeah. Anywho. We may have a similar type of acne.

Hi Lindseym!

Extractions sound painful and frightening. Also, I had no idea your type of acne existed until I saw your old posts and was all "I don't see...well..it's bumpy...why isn't the acne on the OUTSIDE?". You do not have to justify yourself (to me), the camera probably can't pick it up.

Also, do you think there could be a link between some cosmetic/creme/something you're applying to your face and the blocking of your pores? I learned about Paula's Choice and since then have had a really really high regard for the basic quality of her reviews. There are wayyy too many things on the market that are labelled as non comedogenic and have a lot of irritating chemicals. Mostly I'm saying this cause, again, never realised your type of skin issue existed.

So day 3 here, nothing really to report, no side effects as of yet aside from being VERY sore...but I think that may be more from snowboarding yesterday than anything! I wasn't able to get any decent pictures as it snowed a more than a foot so natural light is just blinding here and indoor lighting doesn't really show my bumps....my office lighting is what really brings out the grossness so pics will come tomorrow

Puddlebug ! I would totally do a log if I were you...looking back at my old one helped me chose to do another. Diane 35 BC kept my skin lovely until I had several blood clots and wound up with a heart attack and can not ever be on a hormone BC... my skin doesn't respond to anything aside from Accutane, I am really sad my last round was the longest yet the least successful of them all....my acne started coming back within a few days! I do know how you feel about leaving the house! I dont wear makeup so sometimes I just dont leave the house... I take a look in the mirror and decide to cancel plans... just today I wanted to go swimming with my husband but neck and chest are such a mess I refuse to be seen. Hang in there and keep me updated

Rooth I feel like being in canada is my main issue! every time I go somewhere down south my acne is GONE in a matter of days... no amount of steaming or sunlight up here can replicate the humidity and well salt water!

I don't wear foundation or use any creams that clog pores REN is an amazing line, I have done a lot of research on it and can not say enough about it. I have tried paula's choice with very bad rash reactions so I spend a little extra for my REN products and dead sea minerals from Israel which I really like.... and the gross old cetaphil which as horrible as it looks is tried tested and true apparently non-inflammatory acne is incredibly common... but so many people just ignore it as its a little easier to over look but once sunlight hits or florescent light its a nightmare.

Lindsey, it was Diane and a 2.5 BP that kept me okay for the past 8 years. I stopped taking it to get pregnant, and things stayed okay for a while. Acne started slowly coming back this spring. It was slowly getting worse, so I did the stupid thing and tried to fix it with topicals. I don't even know what went so wrong, but within a few weeks of trying the biacna, things were terrible. Maybe I had a lot of stuff deep under there, maybe it's because I stopped using my regular BP, or maybe I had a bad reaction, I don't know, but I have never had such red, painful, bumpy skin. It's pretty harsh to have to be in this place with my skin, and even worse to have to give up the hope of another kid. But I have to try to be a good mom to the one I've got, and I know if this goes on much longer I will lose it.

I know the Diane is risky, especially at my age, but I was on it for a long time without incident, so I am hoping to be okay.

Rooth - I know about the paranoia! Even though I had great skin for 8 years, there wasn't a day I didn't wake up worried that this was the day it was all coming back. Pretty crappy that it actually did. Alas. I'll still take the paranoia over the actual acne. I've accepted that I will forever be mentally affected by this no matter what happens. Sometimes I think that is not so bad. It sure helps me to be more understanding of the imperfections of others, and not take for granted any good skin days I get.

I am only using products I have used forever and totally trust, even if they aren't as lovely as the things people with normal skin get to use. I totally hear you on the cetaphil thing!

So I'm doing: spectrojel cleanser (the Canadian classic for acne people!), moisturel lotion (the only lotion I completely trust, although it certainly doesn't have the nice absorbency and feel of high end lotions), and vaseline in the dry spots, just straight up. I am also mixing a little BP into my night time routine, because it is the only thing that has helped before and my skin isn't dry enough yet to be angry with me for it. I use proactiv for this - it is the only product in their line I like. It's less sticky and irritating than most similar BP products.

I will look into REN. Right now I am just trying to find ANYTHING that will cover it up a bit and not make it worse. I used to use Maybelline 24 hour foundation, it doesn't seem to break me out, but I have never liked it (it's sticky feeling), so putting more of it on is gross. I have parent teacher interviews this week (I'm a teacher) and I am not looking forward to thinking about what they are thinking when they sit down with someone who had perfect skin when they saw me at the beginning of September, and is now totally messed up. Especially when that is the last thing I should be thinking about. Just trying to keep telling myself it looks much worse to me. Just trying.

Have you decided not to have another baby because of the accutane? how long after being on Accutane did you have your first?

I am a little scared of this myself as my husband and I would like to start a family in a few years.

I have never heard of Zania and it seems I am happy about that! what dosage are you on this time around? higher/lower than before? what day are you on?

Lindsey, it was Diane and a 2.5 BP that kept me okay for the past 8 years. I stopped taking it to get pregnant, and things stayed okay for a while. Acne started slowly coming back this spring. It was slowly getting worse, so I did the stupid thing and tried to fix it with topicals. I don't even know what went so wrong, but within a few weeks of trying the biacna, things were terrible. Maybe I had a lot of stuff deep under there, maybe it's because I stopped using my regular BP, or maybe I had a bad reaction, I don't know, but I have never had such red, painful, bumpy skin. It's pretty harsh to have to be in this place with my skin, and even worse to have to give up the hope of another kid. But I have to try to be a good mom to the one I've got, and I know if this goes on much longer I will lose it.

I know the Diane is risky, especially at my age, but I was on it for a long time without incident, so I am hoping to be okay.

Rooth - I know about the paranoia! Even though I had great skin for 8 years, there wasn't a day I didn't wake up worried that this was the day it was all coming back. Pretty crappy that it actually did. Alas. I'll still take the paranoia over the actual acne. I've accepted that I will forever be mentally affected by this no matter what happens. Sometimes I think that is not so bad. It sure helps me to be more understanding of the imperfections of others, and not take for granted any good skin days I get.

I am only using products I have used forever and totally trust, even if they aren't as lovely as the things people with normal skin get to use. I totally hear you on the cetaphil thing!

So I'm doing: spectrojel cleanser (the Canadian classic for acne people!), moisturel lotion (the only lotion I completely trust, although it certainly doesn't have the nice absorbency and feel of high end lotions), and vaseline in the dry spots, just straight up. I am also mixing a little BP into my night time routine, because it is the only thing that has helped before and my skin isn't dry enough yet to be angry with me for it. I use proactiv for this - it is the only product in their line I like. It's less sticky and irritating than most similar BP products.

I will look into REN. Right now I am just trying to find ANYTHING that will cover it up a bit and not make it worse. I used to use Maybelline 24 hour foundation, it doesn't seem to break me out, but I have never liked it (it's sticky feeling), so putting more of it on is gross. I have parent teacher interviews this week (I'm a teacher) and I am not looking forward to thinking about what they are thinking when they sit down with someone who had perfect skin when they saw me at the beginning of September, and is now totally messed up. Especially when that is the last thing I should be thinking about. Just trying to keep telling myself it looks much worse to me. Just trying.

Day 4: Chapped lips have started and I feel dry skin coming on! woohoo!

Lindsey, I went off the pill a year ago because we were considering another child. We couldn't make up our mind in the end and were leaning more towards no (our current one is 5 in Feb), so I am okay with making this choice. But, yes, I wouldn't be comfortable getting pregnant within a year of the Accutane. Our little man will be 6 by then, so I think it's unlikely I will want to get the diapers back out at that point. It's a little sad to know you won't have more, even when you know it's what you ultimately want. Having kids is awesome.

I did my first round in 2004. Pregnancy was great for my skin. Lack of regular menstruation I think.

My little man was born in 2009, 5 years post Accutane.

He is completely free of any defects, aside from being a bit of an ass since he learned to have an opinion. It's yucky to say that, but the delightful picture on the back of each pack doesn't make any woman feel good.

I don't know how long doctors advise before trying to conceive, since it was a while before we thought of that. You'd have to ask.

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Peeling is bad enough that I will start with my "step 2" night moisturizer... this is normally not necissary until at least a week 6. I had a nosebleed this morning and am absolutely exhausted right now. I feel like a zombie at work.

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I can see what you are talking about more clearly in those pictures. I hate that under the surface stuff you know is just waiting to attack. Everything is coming to the surface for me so I am just all red and spotty. I actually felt a bit better today, though, for unknown reasons. I think because nothing hurts or itches for once. And all sorts of thing are peeling off, so at least something seems to be happening. After so much time watching things get gradually worse and worse, it would be nice for them to start gradually getting better instead.

Glad to hear you are feeling it too! Weird how each Accutane experience is so different, even when the same person is doing it. This is totally different from my first round.

I'm a teacher and tomorrow is parent teacher interviews. I'm just hoping for no new major horrors overnight so I can concentrate on what I'm doing and not worry about everyone staring at my horrible skin. Alas.

good luck with your interviews! one thing I can say is maybe keep a log for yourself... I have gone back to my last one a dozen times already to forecast what I am in for around christmas, or events, and compare then and now lol!

The pictures with the flash from today showed bumps I cant even feel or see otherwise... pretty disheartening, I attacked my face when I got home and sorely regret it... I am sure I will look like the polka dot door tomorrow....and I have a 2 day seminar at work and am picking my horse up from the hospital and talk to all the vets about her surgery so I get to show this face to a lot of people tomorrow! tempted to go tanning at lunch to burn it camouflaged

Considering asking for a referral from my dr to an actual derm as I realized I have NEVER hit the cumulative doses... first round was 1 single package of 40mgs so 1200 total! second round was the same, and third I hit 4800.... in order to him 120mg/kg I need close to 7000.... so I need to be on this for 6 months ! I almost want to go on a higher dose and suck up the stronger side effects... I guess it is common for people to do 80mg one day then 40 the next, then 80 again and so on....

The IB has begun ! my eyes are so sore and red I look like I clean with them steel wool. my chin and nose are the dryest areas...lips are so chaped already they bleed. When ever I blow my nose its generally all blood.

I am stiff and sore all over, I was in a car accident so that is probably more to blame than the Accutane... and I had my first accutane near black out headache in the middle of the night last night.

My dr gave me the ok to be more "agressive" and so I am on 80mg daily rather than 40 so that my course will be over in 3 months instead of 6

taken so far: 600mg

Goal total of course: 7090mg

left:5890

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pretty frustrated today, ...still day 11 but I have 3 actives at once.... I know the only time I get inflamed acne is when I am on accutane and I like to believe this is my skins way of bringing things out but I have 3 painful ones that are about the size of a pea ...super red...super hard...and even my hair touching them hurts! You would think with my broken ribs any everything else I wouldnt even notice them ! but ouch, never knew a bloody pimple could hurt so much.

I think we are acne opposites. I don't get a lot of cloggy pores, but when I do they get infected almost immediately and become ugly and painful. I don't know what the hell went wrong with my attempt at using the tretinoin cream, but it caused me WAY more cloggy pores than I've ever had in my life. Now they are all getting angry, one by one. I think I have about 5 actives on my face. I try not to count because it's so ridiculous right now. And they are (almost) ALL on my chin. My chin is disgusting while the rest of my face looks pretty normal. What is up with that?! And on top of the actives, the ones that do go away leave behind crazy dry spots that are harder to cover up than the zits they came from. I am too old for this - this is going to leave scars I think. I am so with you on the feeling ugly, except that when I look at your pictures I think you look pretty lovely!

Alas. I keep telling myself it is still early (day 18 for me). I am just soooooo looking forward to the day when I wake up and think 'hey, that actually looks a little better AND IT DOESN'T HURT!'.

You look great. I definitely don't see any pea sized zits - when I get those my whole face swells up and I know, because I have a few right now. You don't look like that at all. I don't know how you are handling all those side effects! I have the chapped lips, but I have never had a bloody nose or terrible headache (knock on wood). I have never been able to take 80mg. My doctor advised last time to try doing 80 every other day to get through quicker. I tried it twice, and both times when I took the second pill of the day I got suddenly nauseous within about ten minutes and threw it up. This was quite unpleasant and seemed like a waste of money, so I haven't tried it again yet. I would be afraid to now because my IB is so bad. More might make my chin explode. Maybe later. Although I actually wouldn't mind doing the six months if my side effects stay the same.

Anyway - keep me updated. It helps to see other people going through what you are going through. Last time I did this, my skin just got better and better from almost day 1. This time, not so much, so it's nice to know I'm not the only one with a few nasty zits already a few days in. Thanks for that, even though you do look fabulous and that is a bit irritating for me!

My step 2 lotion (ann borlind rosedew has really helped with the dryness! and the aquaphor lips are a savior!!)

cleansing more often with my minderal of the dead sea wash as I feen a much better clean with it and never have reactions. I am going to keep it as my morning time AND evening cleanser. My morning/daytime moisture is still my REN so no changes there

Skin is RED dry and cracking all around my nose, skin all over my body is dry and tight. Was hospitalized this week losing consciousness and seizing so I am tired and in pain all over so I don't even feel the accutane side effects.